JEAN WEDNER ROUSSEAU (NPI# 1750485900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750485900 |
| Entity Type | Individual |
| Full Name | JEAN WEDNER ROUSSEAU |
| Credential | MD |
| Practice Address |
4140 Hollywood Avenue Shreveport LA 71109-7818 |
| Practice Telephone | 3186219600 |
| Practice Fax Number | 3186210169 |
| Mailing Telephone | 3186219600 |
| Mailing Fax Number | 3186210169 |
| Enumeration Date | 2006-09-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 06203R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1334022 | 05 |
| Street Address |
4140 HOLLYWOOD AVENUE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71109-7818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784416 | Barbara Smith | Counselor | 4019 Greenwood Road, Shreveport, LA 71109 | 2017-08-01 |
| 1508306135 | Cherise Sims | Case Manager/Care Coordinator | 3512 Greenbriar Dr, Shreveport, LA 71109 | 2017-03-01 |
| 1174063093 | Nitika Pinesett | Case Manager/Care Coordinator | 3011 Independence Ave, Shreveport, LA 71109 | 2017-02-24 |
| 1831640986 | Aleric Hamilton | Counselor | 2605 Leaf Ln, Shreveport, LA 71109 | 2016-10-24 |
| 1144673963 | Lakeishia Johnson | Technician | 5342 Broadway Ave, Shreveport, LA 71109 | 2016-07-16 |
| 1083074223 | Patricia Pouncy | Counselor | 4019 Greenwood Rd, Shreveport, LA 71109 | 2016-03-01 |
| 1326418518 | Deepasulochana Sivasankaraganesan | Dentist | 3719 Jewella Ave, Shreveport, LA 71109 | 2015-09-30 |
| 1063611838 | Della Edwards Wills | Social Worker | 4615 Monkhouse Drive, Ste A-2-b, Shreveport, LA 71109 | 2007-07-12 |
| 1083743041 | An Endless Love Home Care, LLC | Point of Service | 6259 Tinker Street, Shreveport, LA 71109 | 2007-03-05 |
| 1316009624 | Djenane Rousseau | Pharmacist | 4140 Hollywood, Shreveport, LA 71109 | 2006-12-14 |
| Find all providers in zip 71109 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1548408628 | Wk Pediatric Eye Specialists | General Practice | 1202 Louisiana Ave, Shreveport, LA 71101-3910 | 2009-01-28 |
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| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.